Last Friday, I had the honour to host some of the leading researchers in historical pain studies at a one-day conference. Together, we probed chronic pain in the Middle Ages, breaking new ground as the first ever international, interdisciplinary academic meeting on this topic. Papers showcased the latest research in this area, highlighting the diversity of approaches needed to grapple with the multi-faceted nature of chronic pain.

We came together with some answers, it's true. But mostly, we met to ask questions, and plenty of them - on methodology, on sources, on ethics, on modern relevance, and more - in our collective pursuit of establishing the field. (For the conference's original Call for Papers which lays out the central topics of papers and our informal discussions, see here.) Below, I've posted resources to give a flavour of the meeting, and of our preliminary findings from the conference. You will find:

the full conference programme;

a transcript of the day's proceedings;

a Wakelet of the full live-tweet from the day.

There are several last-minute amendments to the conference programme. Firstly, three speakers sadly could not be with us, one from each panel: Katherine Harvey, Catherine Coffey, and Bianca Frohne. Due to some tech-based shenanigans, we could not have a video livestream. However, as a work-around, all panels and the keynote were recorded as audio files, which have now been transcribed. If you'd like to download the transcript as a .pdf, please see here. (Note, however, that the embedded transcript below is the truly final version, which has some corrections in that are missing in the pdf. The two documents also have different pagination.)

The day before the conference, I hosted a #certainpain Twitter chat. Questions revolved around the utility of historical pain studies for people living with chronic pain today. Spoiler alert! I argued hard for the intrinsic worth of such scholarship for the modern chronic pain community:

Representation *matters*. Be that contemporary media representation, political representation, or historical representation. [1] & being able to recognise that you are not alone, isolated in history - but others have come before you & lived is important [2]

The conference demonstrated amply that modern chronic pain sufferers are certainly not 'isolated in history'. In virtually every kind of document we have from the Middle Ages - personal letters, law, theology, romance narratives, hagiography, and so on - we can find traces of chronic pain experiences. Our work is now to bring these traces to greater light.

I blogged previously about the public workshop on chronic pain I've been organising. I can happily report that the day went very well, with exciting and insightful presentations and lots of productive - and often provocative - discussions. To maintain anonymity of our attendees though, we didn't film the Open Forum with which we ended the day. Below you'll find several ways to access the main content of the workshop:

the programme (with speaker biographies)

the recorded livestream (on YouTube)

a full transcript of the livestream video

a Storify of all relevant tweets from the day.

Please feel free to share a link to this post widely, so as to disseminate the workshop findings as far and wide as possible!

Q1 Are you interested about the history of treating and managing (chronic) pain? Why, or why not?

Q2A Do you think that studies of historical chronic pain – i.e. experiences of people living with chronic pain throughout history - are worthwhile? Why (not)?

Q2B In your opinion, do such studies – or could such studies – meaningfully impact your own experiences of living with chronic pain today?

Q3 What kinds of historical scholarship on chronic pain would you be interested in that are presently neglected or hard to learn about? Are there any areas you would like scholars to work on in particular?

Q1 Do you have any role models in navigating life with chronic pain? Who are they?

Q2 What makes a good role model in this context?

Q3 Are you aware of people living with chronic pain in your professional or educational life?

Q4 Is it beneficial to you if people in positions of authority – such as senior colleagues at work, or lecturers in school – disclose the fact that they live with chronic pain, or other chronic conditions? Why?

Registration is now open for the workshop on chronic pain, Saturday 19 August 2017. This is a completely free event, bringing together academics, medics, activists, and people living with chronic pain. For a full run-down of the day, please see here.

Registration is essential for this event - it means we can order enough cake, for one thing! - so please take a moment to click through to Eventbrite to confirm your attendance if you'd like to take part. And please email me directly if you have any dietary or access requirements, as these aren't captured by the Eventbrite.

I am so looking forward to this event - and taking part in exciting, important conversations inspired by presentations from some of the leading thinkers and researchers on chronic pain that will take the floor in the workshop. I hope to see some of you there!

Q1 How do you manage your pain, on a day to day basis? For example, do you use painkillers or other medications? What about methods to manage your pain which don’t involve medical drugs, such as massage, exercise, etc?

Q2 How has your pain management strategy developed over time?

Q3 Do you feel that your medical team has offered you enough support in developing ways to cope?

Q4 What are your thoughts on ways to treat chronic pain that don’t involve medical drugs? For example, do you feel informed about these “non-pharmacological” approaches?

Pain is a universal human experience. We have all hurt at some point, felt that inescapable sensory challenge to our physical equanimity, our health and well-being compromised. Typically, our agonies are fleeting. For some, however, suffering becomes an artefact of everyday living: our pain becomes ‘chronic’. Chronic pain is persistent, usually lasting for three months or more, does not respond well to analgesia, and does not improve after the usual healing period of any injury.

Following Elaine Scarry’s (1985) seminal work The Body in Pain, researchers from various humanities disciplines have productively studied pain as a physical phenomenon with wide-ranging emotional and socio-cultural effects. Medievalists have also analysed acute pain, elucidating a specifically medieval construction of physical distress. In almost all such scholarship – modern and medieval – chronic pain has been overlooked.

The new field of medieval disability studies has also neglected chronic pain as a primary object of study. Instead, disability scholars in the main focus on ‘visible’ and ‘mainstream’ disabilities, such as blindness, paralysis, and birth defects. Indeed, disability historian Beth Linker argued in 2013 that ‘[m]ore historical attention should be paid to the unhealthy disabled’, including those in chronic pain (‘On the Borderland’, 526). This conference seeks specifically to pay ‘historical attention’ to chronic pain in the medieval era. It will bring together researchers from across disciplines working on chronic pain, functioning as a collaborative space for medievalists to enter into much-needed conversations on this highly overlooked area of scholarship.

Relevant topics for this conference include:

Medieval conceptions and theories of chronic pain, as witnessed by scientific, medical, and theological works

Paradigms of chronic pain developed in modern scholarship – and what medievalists can learn from, and contribute to, them

Prof Esther Cohen (Hebrew University of Jerusalem), one of the foremost scholars on pain in the Middle Ages, will deliver the keynote address.

Members of the Society for the Social History of Medicine may apply for bursaries to facilitate attendance at this conference. Please see here for full details.

The conference registration fee is £20. The fee is waived completely for concessions (students, the unwaged, retired scholars). Registration for the conference will open shortly, and be conducted via the UCL Online Shop, in the ‘Conferences and Events’ category.

If you have any queries, including access requirements, please do not hesitate to contact the organiser, Alicia Spencer-Hall (a.spencer-hall [at] ucl.ac.uk).

Logos for Society for the Social History of Medicine and the Institute of Advanced Studies at UCL.

Since last autumn, I've been running a Reading Group for the discussion of texts relevant to chronic pain, and sensory disorders more generally. (For details of the Reading Group, including how to join and our meeting schedule, see here.) Below, I've provided the bibliography for each session, which works as a primer for key texts in the area of chronic pain and allied issues, including disability and illness studies. I'll be updating this page on an ongoing basis, so watch this space for more readings.

Whenever possible, I've provided links to the readings online to maximise accessibility to the materials. Unfortunately, some pieces are either only available hardcopy or behind paywalls online. If you'd like access to readings as .pdfs, please email me to join the Reading Group, and I will add you to the email list to which I send out .pdfs of our selected readings in advance of our scheduled meet-ups.

Reading Group 1 - Statistics and Logistics of Chronic Pain in the Medical Establishment

Q2 Have your experiences of living with chronic pain affected your political beliefs in any way? For example, have they influenced your decision to support a particular political party or candidate?

Q3 With Donald Trump's Inauguration as President of the USA and Brexit in the UK, there is a lot of political upheaval at the moment. Do such events, and/or the associated political uncertainty, affect your pain levels, and the ways in which you manage your condition?

Q4 Has your pain ever limited your involvement in the political process?

Next week, I’ll be hosting the first in a series of monthly Twitter Chats to talk about what it’s like to have chronic pain, and to discuss ideas from my ongoing research with the chronic pain community. For the Chats, I’ve chosen the hashtag #certainpain. I agonised over picking a Chat hashtag. Selecting a hashtag felt very editorial, like I was implicitly directing or limiting the Chats’ content to a superficial pseudo-slogan: “The hashtag is X, so we can only talk about X.” This is directly at odds with my aims for the Chats themselves: to provide an open space for empathetic dialogue. Certainly, I will be facilitating the conversations, and providing stimulus for contributions. But, the point of the Chats is to hear the thoughts and opinions of those who deal with chronic pain about ideas, theories, and frameworks which crop up in academic scholarship, texts which so often de-emphasises – or at worst fail entirely to consider - the real bodies and real subjects they analytically dissect. Somewhat ironically, perhaps, as I progressed in my hashtag decisions, I was drawn back to the sensory reality of my own body as a means of centering my thoughts.

For those unfamiliar with Twitter Chats, a quick explanation is necessary. (For a run-down of Twitter Chat basics, see here and here.) In a Chat, all participants “mark” their responses by using a pre-defined hashtag to show that they are, in fact, taking part in the Chat. A pre-defined hashtag also allows others to more easily follow along with the Chat, and dip into the conversation if they feel like it. So, for example, by including #certainpain in a tweet, an individual is flagging the fact that they are contributing to this specific topic, and/or specific Chat in particular, and not just tweeting their thoughts more generally. The hashtag lets you filter out the substance of a Chat from the background noise of the rest of the myriad conversations happening on Twitter at any given moment.

Guidance on choosing a Chat hashtag available online underscores that the hashtag should be:

Short

A tweet is limited to 140 characters. A long hashtag reduces the amount of characters left for participants to express themselves, and so is counter-productive to the aims of a Chat: to start a dialogue and hear from interested parties.

Unique

The point of a hashtag is to signpost a specific conversation, organised around a topic and often with a short series of questions to kick-off discussions. If your hashtag is already used for another Chat series, or in common usage on Twitter already, then your Chat is subsumed into a torrent of other tweets. So, for my purposes, #pain, #chronicpain, #painchat were all ineligible. You’re also advised to check that a hashtag hasn’t been used for obscene, or otherwise problematic, content. Not ideal, to say the least, if you accidentally associate your Chat with gonzo pornography or a Neo-Nazi meet-up thanks to a shared hashtag.

Relevant

A Chat hashtag must be easily identifiable as being related to the general topic under discussion. This means that Twitter users who may not necessarily be aware of the Chat’s existence or specific designated subject can, at a glance, get the gist of the content. So, for example, the hashtag #iasmedieval would be pretty useless. #iasmedieval flags that I’m based at the IAS (Institute of Advanced Studies at UCL), and that I’m focussing on medieval sources in my academic research project. All of this is true. But #iasmedieval is meaningless in the context of the Chats I’m hosting:

“ias” is a mysterious acronym to those not in the know;

“medieval” captures only my personal research agenda, and not the central thrust of the Chats – to open up discussions about the experiences of chronic pain today;

the fact that pain is central to the Chats is completely hidden to those casually following along on Twitter.

So, why #certainpain? On a practical level, it fulfils the criteria set out above: short (enough), unique, and relevant. Tick, tick, tick. More than that, though, it highlights some of the significant issues at stake when we talk about chronic pain, encapsulated by the insertion of "certain".

This is as good a place as any to “out” myself as a #spoonie (a descriptor derived from Spoon Theory), a member of the chronic pain community. Early on in my chronic-life, I was assigned Elaine Scarry’s 1985 book The Body in Pain to read for an undergraduate module on the not-overly-broad-at-all topic of “The Body”. It was a revelation. I was in the medical merry-go-round stage of post-diagnosis living: trying to establish a viable treatment plan for my fibromyalgia and going to countless appointments with doctors and practitioners of every stripe, or so it seemed. With a dark humour, I used to pointedly read The Body in Painin waiting rooms. The sentence from the book that most struck me, and has entered my personal lexicon of useful maxims? “To have pain is to have certainty; to hear about pain is to have doubt” (p. 13; emphases in original). Right there in a two-decades-old monograph, Scarry captured the organising tenet of my life at that point. Every medical and institutional interaction – not to mention a fair few social interactions too – seemed to revolve around the unavoidable, insistent fact of my pain butting up against the inability of others to comprehend my pain, or even to believe in it fully.

I was "certain" about my pain - a trustworthy witness to and narrator of my body's sensory misfiring. The pain itself was a "certainty" - an inevitable, "reliable" part of my existence that stubbornly refused to go away. In these statements, I'm drawing on the Oxford English Dictionary's definition of the adjective "certain" in terms of sure-ness, authenticity, factual reality (see images below).

"certain" (I.1.a) in the Oxford English Dictionary (Online).

"certain" (I.2.a) in the Oxford English Dictionary (Online).

"certain" (I.2.b) in the Oxford English Dictionary (Online).

"certain" (I.3) in the Oxford English Dictionary (Online).

The OED provides other definitions of the word "certain" too. Take, for example this definition, which highlights the popular usage of "certain" to connote that which is "not polite or necessary further to define":

"certain" (II.7.e) in the Oxford English Dictionary (Online).

Chronic pain is a "certain" kind of pain, the "bad" kind - the kind that just doesn't get better, or go away. To have chronic pain is to embark upon a chronic life, as the pain forcibly impacts almost all aspects of one's daily living, views on the world, even hopes and dreams. It is uncomfortable to consider, this "certain" kind of pain - about how one copes with perpetual pain. The specter of becoming afflicted oneself looms large in the mind of the nominally "healthy", however sublimated this anxiety may be. Better avoid the issue, and focus on happier things. It is not "polite" to discuss chronic pain, which has been neglected as an area of concentrated study even in academic scholarship. What's more, pain itself is fundamentally euphemistic: we cannot express fully in language our pain, really share how and in what why we hurt. And so, euphemisms and metaphors become central to the chronic-pain linguistic toolkit.

It is not that it is "not [...] necessary further to define" chronic pain - quite the opposite, much more research is needed in the area. But again, another nuance of the word "certain" comes into play:

"certain" (II.7.a) in the Oxford English Dictionary (Online).

Chronic pain is an amorphous and vague descriptor. By this, I mean specifically that "chronic pain" is an umbrella term for potentially myriad different little-understood operations which then result in the similar, if not identical, effect of an unceasing pain response. (For discussion of the limits of our contemporary medical understanding of pain responses, and chronic pain, listen in particular to this Guardian Science podcast, featuring specialists Prof John Wood and Dr Natasha Curran. Prof. Wood notes at c. 6 minutes in that "pain perception itself is completely mysterious" currently.) So, chronic pain is a "certain" pain - bracketed off from acute pain, but a phenomenon (or bundle of phenomena) about which we actually know very little.

In the above, my personal experience of chronic pain looms large as a lens through which I filter my analyses and my hypotheses. Yet, all pain is subjective. That is: no one can ever share another’s pain experience directly, be that in cases of acute or chronic pain. (On the differences between the two, see this brief primer by the Cleveland Clinic.) I have no idea if others' experience of pain mirrors my own. In other words, I experience only a "certain" kind of a "certain" kind of pain. And so, finally, that ineluctable specificity of experience underpins the #certainpain hashtag. We each live with our own specific pain, shaped and understood by our own context(s). A metaphorical picture of chronic pain can never be monotone or univocal. Rather, it is a polyphonic mosaic of hugely variable meanings, feelings, and experiences. It is my sincere hope that by entering into dialogue with one another, whether by participating in the #certainpain Twitter Chats or others similar endeavours online and in-person, we can share as best we can our divergent and necessarily specific experiences and thereby forward our understanding of "chronic pain" more generally.

Pain is a universal human experience. We have all hurt at some point, felt that inescapable sensory challenge to our physical equanimity, our health and well-being compromised. Typically, our agonies are fleeting. For some, however, suffering becomes an artefact of everyday living: our pain becomes ‘chronic’. Chronic pain is persistent, usually lasting for three months or more, does not respond well to analgesia, and does not improve after the usual healing period of any injury.

Following Elaine Scarry’s (1985) seminal work The Body in Pain, researchers from various humanities disciplines have productively studied pain as a physical phenomenon with wide-ranging emotional and socio-cultural effects. Medievalists have also analysed acute pain, elucidating a specifically medieval construction of physical distress. In almost all such scholarship – modern and medieval – chronic pain has been overlooked.

The new field of medieval disability studies has also neglected chronic pain as a primary object of study. Instead, disability scholars in the main focus on ‘visible’ and ‘mainstream’ disabilities, such as blindness, paralysis, and birth defects. Indeed, disability historian Beth Linker argued in 2013 that ‘[m]ore historical attention should be paid to the unhealthy disabled’, including those in chronic pain (‘On the Borderland’, 526). This conference seeks specifically to pay ‘historical attention’ to chronic pain in the medieval era. It will bring together researchers from across disciplines working on chronic pain, functioning as a collaborative space for medievalists to enter into much-needed conversations on this highly overlooked area of scholarship.

Prof Esther Cohen (Hebrew University of Jerusalem), one of the foremost scholars on pain in the Middle Ages, will deliver the keynote address at the conference.

Relevant topics for this conference include:

Medieval conceptions and theories of chronic pain, as witnessed by scientific, medical, and theological works

Paradigms of chronic pain developed in modern scholarship – and what medievalists can learn from, and contribute to, them

Recognition or rejection of chronic pain as an affirmative subjective identity

Chronic pain and/as disability

The potential share-ability of pain in medieval narratives, such as texts which show an individual taking on the pain of another

The relationship between affect and the severity, understanding, and experience of pain

The manner in which gender impacts the experience, expression, and management of an individual’s chronic pain

If you’re interested in speaking at the conference, please submit an abstract of 250-300 words and a brief bio to the organiser, Alicia Spencer-Hall (a.spencer-hall [at] ucl.ac.uk), by 1 March 2017. Please also stipulate your audio-visual requirements in your submission (e.g. projector, speakers, and so forth).

NB. Speakers will need to register for the conference in due course. The registration fee is £20. The fee is waived completely for concessions (students, the unwaged, retired scholars).

If you have any queries, including access requirements, please do not hesitate to contact the organiser.

This conference contributes to the ‘Sense and Sensation’ research strand at UCL’s Institute of Advanced Studies. This strand also comprises a Reading Group focused on chronic pain. To join the Reading Group, please email the organiser, Alicia Spencer-Hall (a.spencer-hall [at] ucl.ac.uk).

[Updated on 18/01/17, to reflect extended deadline for receipt of abstracts.]

This bi-monthly Reading Group, based in UCL's Institute of Advanced Studies, provides a collaborative space for researchers from various disciplines to discuss theoretical understanding(s) of the senses in a state of disorder, drawing from well-established approaches and recent cutting-edge paradigms alike. Our chief focus will be on chronic pain, though works which deal with dysfunctional senses more generally will also be part of our corpus. Chronic pain is persistent, usually lasting for three months or more, does not respond well to analgesia, and does not improve after the usual healing period of any injury. The phenomenon, then, equates to sensory ‘misfiring’: the experiences of chronic-pain sufferers testify to the very real sensations provoked when normal neurological and biological functions ‘go wrong’, when the senses act seemingly according to their own ‘logic’.

What happens when the senses go awry, when sensory input no longer makes ‘sense’ to the human subject? How do those with seemingly malfunctioning senses deal with such phenomena? How does the medical establishment deal with such cases, which are often incredibly difficult to remedy? Should a ‘cure’ be the aim of medical interventions in all cases of sensory dysfunction? In what ways do senses that don’t make rational ‘sense’ challenge our ideas about the relationship(s) between the body, the mind, and our communities? These are some of the questions that will be under discussion in our meetings, guided by the selected texts under discussion.

Sessions will take place at 4-6pm on the following Thursdays during the academic year 2016-2017:

Please contact Alicia Spencer-Hall to be added to the Reading Group e-mail list and receive .pdfs of the texts under discussion. Please also don’t hesitate to get in touch if you have any queries, including access requirements.

The Reading Group is intended to be an open, flexible, and collaborative forum. As such, suggestions for reading material(s) to be consulted in future sessions are enthusiastically welcomed! Texts which focus directly on chronic pain, or those which more broadly treat the topic of sensory dysfunction are equally eligible. If you would like to propose works for our discussion, or informally chair one of our meetings around a specific theme, please contact the organiser.

Update: Want to see what we've read so far? Check out the bibliography here.

Here's a poster about the Reading Group - feel free to share as you see fit!

As of October 2016, I am embarking upon a new research project, entitled 'A Certain Suffering: Chronic Pain in Medieval France and England, c. 1100-c.1400'. My home for the next year is UCL's Institute of Advanced Studies, where I am one of two Junior Research Fellows interrogating the broader theme of 'Sense and Sensation'. Below, I sketch out the contours of the project, including some key areas of investigation I hope to probe. Over the next few months, I'll also be conducting a variety of research-led activities, including a Reading Group, Twitter chats with chronic pain sufferers, a medievalist conference, and a workshop for pain sufferers, academics, and medics. I've created this new 'Chronic Pain Project' section of the blog to corral all posts relating to this research, and I'll be posting details of all such events - so watch this space!

Project Outline

Pain is a universal human experience. We have all hurt at some point, felt that inescapable sensory challenge to our physical equanimity, our health and well-being compromised. Typically, our agonies are fleeting. For some, however, suffering becomes an artefact of everyday living: our pain becomes ‘chronic’. Chronic pain is persistent, usually lasting for three months or more, does not respond well to analgesia, and does not improve after the usual healing period of any injury. Following Elaine Scarry’s (1985) seminal work The Body in Pain, researchers from various humanities disciplines have productively studied pain as a physical phenomenon with wide-ranging emotional and socio-cultural effects (e.g. Boddice 2014; Cohen et al 2012; Davies 2014; Morris 1991; Moscoso 2012). Medievalists have also analysed acute pain, elucidating a specifically medieval construction of physical distress. Pain could be viewed as a positive, even welcome, experience in the Middle Ages (see e.g. Cohen 1995, 2000, 2010; Easton 2002; Mills 2005; Mowbray, 2009). Equally, pain loomed large in spectacular medieval punishments that concretised mechanisms of social control (see e.g. Merback 1999). In almost all such scholarship – modern and medieval – chronic pain has been overlooked. My research remedies this oversight, focusing directly on depictions of chronic pain in medieval texts.

The project’s central research questions are: how is chronic pain depicted in medieval narratives? What stories do chronic pain sufferers tell to make their pain relatable, even shareable? What stories do those around the sufferer tell in order to understand the pain they witness? Are such narratives different in the medieval period, in comparison to those utilised in the modern period? Pain affects all human subjects across time, resisting any easy classifications of ‘medieval’ and ‘modern’ by its nature as a universal physical experience. The ways in which we conceptualise and express the experiences of pain, however, are definitively linked to the cultural and social frameworks inhabited by a sufferer in a given era. This study, then, dissects universal and temporally-specific experiences of chronic pain.

The new field of medieval disability studies has also neglected chronic pain as a primary object of study. Instead, disability scholars in the main focus on ‘visible’ and ‘mainstream’ disabilities, such as blindness, paralysis, and birth defects (see, e.g. Eyler, 2010; Godden and Hsy 2013; Metzler 2006, 2013; Pearman 2010; Wheatley 2010). Indeed, disability historian Beth Linker argued in 2013 that ‘[m]ore historical attention should be paid to the unhealthy disabled’, including those in chronic pain (526). I emphatically concur. My project directly addresses chronic pain and those who suffer from it, thereby pushing scholarship beyond current limitations. In this research, I engage with modern and medieval theoretical models of incurable pain – its causes, effects, and management – to uncover points of contact and divergence. It will enable us to rethink chronic pain in medieval culture, and hence to re-evaluate current attitudes to the phenomenon more generally. Furthermore, recent research by psychologists and pain specialists has demonstrated the central role of emotions in the incidence and management of chronic pain. Emotions directly impact on physical sensations. For example, a low mood will make pain feel more severe (Tang et al 2008). My research disentangles the interactions between emotions and medieval chronic pain experiences, thereby also developing the new field of the history of emotions.

Beth Linker (2013) also seized upon an important facet of chronic pain: its capacity to destabilise the categories of illness, well-being, and disability (see also Brookoff 2005; Wendell 2001). Chronic pain is a ‘disease-less disease’, symptomatic of a ‘misfiring’ sensory response – there is no physical damage, yet the body still feels pain. Studying this phenomenon, then, forces us to consider questions of bodily and intellectual agency in the midst of physical discomfort. Can you ever feel ‘healthy’ when in chronic pain? Can you experience well-being whilst feeling that pain? Can that pain even be empowering? Such questions are particularly important to consider given the high incidence of chronic pain in the UK today. In 2008, the British Chief Medical Officer Sir Liam Donaldson estimated that 7.8 million Britons live with chronic pain (34). This number is ever increasing: each year over 5 million people develop chronic pain, but only two-thirds will recover. The National Pain Audit, conducted 2009-2012, demonstrated that chronic pain sufferers ‘endure a very low quality of life’ compared to sufferers of other conditions (British Pain Society and Dr Foster Research Ltd. 2012, 40). Moreover, 41% of the Audit’s participants felt that their local pain specialist did not help them in managing or understanding their pain (35). Greater understanding of chronic pain is desperately needed to improve individual experiences and broader medical practices.

Revealing the ways in which medieval sufferers attempt to share their pain narratively – and the kinds of narratives they are offered by social structures including medical practitioners, the Church, romance ideals and so forth – will better enable key stakeholders to listen to modern sufferers on their own terms, and ultimately permit all parties to talk more directly about improving patient care. Interrogating chronic pain allows us to speak to a wide variety of illnesses, as the phenomenon is often a symptomatic component of many diseases, including arthritis, IBS, and cancer.

Why turn to the Middle Ages to better understand modern chronic pain? I maintain that medieval frameworks for living with chronic pain have a lot to offer us. Specifically, in the Middle Ages, the experience of chronic pain was considered a valid – and potentially deeply positive – marker of social identity. Further, pain was represented as a shareable entity, quite literally travelling from body to body. For example, a medieval saint could take on the purgatorial sufferings of another individual to ‘work them off’ in their own body (Spencer-Hall 2015). How can we harness this approach of share-ability in the modern context to improve patients’ lives?

Pain is a fundamentally subjective and isolating experience; an individual cannot directly share in another’s physical pain, and pain itself often exceeds normal language. To transmit the essential nature of their experience to others, however, pain sufferers often turn to imaginative language and evocative narratives. Fictional texts capture these inventive articulations, showing the ways in which pain is linguistically constructed by and for sufferers, and the narrative frames of reference on offer for those in pain. With this framework, modern criticism that demonstrates the ways in which individuals suffering from illnesses deploy specific linguistic forms and narrative motifs will offer a potent heuristic with which to reconsider medieval depictions of chronic pain (see e.g. Frank 1991, 1995; Garro 1992; Jackson 1999). I do not intend to borrow anachronistically the contextual outcomes of modern theories. Instead, I borrow their questions, using the voices of modern sufferers that are embedded in such scholarship to talk back to, and with, medieval suffers.

Against this broader project backdrop, I am currently concentrating on two issues in particular: gender and temporality. Studies of medieval pain in a religious context almost exclusively focus on cases of suffering in the lives of holy women. I hope to offer a welcome corrective to the holes in present criticism, by studying the phenomenon of chronic pain in biographies of medieval holy men. Do holy men suffer differently than holy women? Are men subject to different kinds of (mis)treatment because of their pain? To what extent does gender play a role in the medieval experience of pain, in a religious context? Or is gender secondary to religiosity - i.e. the accepted holiness of a sufferer - in terms of the experience of chronic pain?

Modern scholarship of chronic pain brings to the fore the temporal effects of the experience of disability and chronic pain, which often leads to sufferers feeling ‘out of step’ with ‘normal’ time (Godden 2011; Hellström 1998; Hellström and Carlsson 1997; Morris 2010; Toombs 1990). The temporal ambiguities provoked by chronic pain lend additional analytical productivity to a methodology based on combining modern and medieval materials. For example, do chronic pain sufferers exist – at least narratively – on a separate timeline than ‘normal’ individuals? In this, then, do medieval and modern chronic pain patients actually have a significant shared temporal/existential stance? Does my methodological approach, bringing modern theories in touch with medieval theories, mirror the inherent structure of chronic pain sufferers as community across time?